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Chances of high HEMOGLOBIN level to form BLOOD CLOT.

Resolved Question:

Does high hemoglobin increase the chance of forming a blood clot independently of the INR level?

Background:
I am on dialysis and have been told by my dialysis nurse that I must keep my hemoglobin less than 11.5 to prevent fistula clotting. Yet I am on warfarin to keep my INR above 2 to decrease risk of clotting in my heart which has muscle damage. I believe that if the INR is high enough to prevent clotting in the heart it will also prevent clotting in my fistula, regardless of hemoglobin level. Am I right? I realize there are other factors that may cause fistula clotting, related to preventing a strong blood flow.

Category: Family Physician-GP

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Category: Diabetologist
 18 Doctors Online

Hello,
Thankyou for your query at DoctorSpring.com
From your reports, it appears as if your LDL cholestrol is consistently higher than desirable.It should ideally be less than 130, this is also the reason why your total cholesterol is higher than normal.
As a first line, patients are always advised to make changes to their lifestyle before a need for medications is considered. Since your levels are not dramatic enough to start off with medication I would like for you to try the following are the dietary recommendations first which I feel will bring better control of your levels

  • Choose foods with low cholesterol and saturated trans fat. Aim for a dietary pattern that limits saturated fat to 5 to 6 percent of daily calories and reduces the percent of calories from trans fat.
  • Limit your intake of red meat and dairy products made with whole milk to reduce. Choose skim milk, lowfat or fat-free dairy products. Limit fried food, and use healthy oils in cooking, such as vegetable oil.
  • A diet high in fiber can help lower cholesterol levels by as much as 10 %
  • A weight loss of 10 percent can go a long way to lowering your risk of or reversing hyperlipidemia.
  • Consider exercise of atleast 120 minutes per week
Hope this helps, feel free to discuss further


Patient replied :

Dear Doctor, Thanks for your reply. I do not take milk or milk products at all. I do not eat eggs or meat. I do surya namskar and asanans for one hour a day with out fail. Millets , hand pound rice , chappatis, vegetables and fruits form 99% of my diet. I medidate for 30 to 45 mts a day. I lost weight from 67 ks to 60 kgs over a period of 4 years after I transformed my life styl into more of yoga, meditation . and sadhvik food. My height is 6.5 feet. I am absolutely free from stress both at office and home. To support my yoga, I take two meals a day. One 10 AM and the other 7 PM. At 3 Pm I take fruits. Nothing in between. No coffee . No snacks.
1) Hence I am puzzled why LDL is high and what more I can do to bring it down ?
2) How often I can do the lipid profile test to know the effect of dietary change on the LDL level ?


Hello,
Thank you for your follow up query.
Your current weight and lifestyle choices seem excellent. Good job taking such good care of yourself!
Yes, admitedly your LDL is higher than normal, what it does not need too much concern, especially in light of the fact that your HDL (the desirable, protective kind of cholesterol) is higher than required.
Therefore the only recommendation I would make is to include 30 minutes of exercise aside from the yoga. Exercise includes those activities which would take your heart rate up (such as brisk walking or aerobic excercise) as this would burn your fat (which is composed of cholesterol).
Hope this helps, feel further to discuss further


Patient replied :

Many thanks Doctor.

I am right away starting jogging 30 mts a day. One more last question on this topic.
When again I can check lipd profile to know the effect of jogging. After a month ? or after 3 months ?


Hello,
Yes, I would suggest that you recheck your levels in 3 months. Considering your levels are not very concerning, it wouldn't be a problem if you recheck it in 6months too.
Good luck, feel free to discuss further


Patient replied :

Dear Doctor,

As per your advice I exercised and did the LIPID profile test and the results are good. I have enlosed the test results done in April 2015.
I left jogging because I was getting pain in my left knee.
Now I have the tests and the results are enclosed. I did additional blodd test and vitamin tests.
I have enclsoed the test report . Please provide your observations, suggestions and advice


Hello,
This consult was initiated over an year back and hence will be closed by the system.
We keep consults open for one month or till 3 fups have been utilised.
You will need to initiate a new consult to continue the consultation further.
Regards.


Dr. Jaydeep Tripathy
Category: Diabetologist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Senior Residency in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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